Faith Formation Registration Form (CCD)

 

 

                                               ST. TIMOTHY / SAINT RITA FAITH FORMATION                    Office use only
                                                                     2019-2020                                                                Date:___________

                                                              NEW REGISTRATION                                                    Paid:___________

                                                                                                                                                       Check #:_________

 

All classes are held on Sundays.  Children in Grades K-5 meet from 10:00 AM-11:15 AM. – Students in Grades 6-10 meet from 6:00 -7:15 PM..  Attendance at Mass constitutes part of the teaching. All classes meet in accordance with a set schedule.  You must be registered at St. Timothy Church or St. Rita Church for your child/children to participate in our Faith Formation program. 

 

Are you a registered member of St. Timothy Parish?   _____Yes  _____ No, St. Rita Parish? ____Yes_____No.  If not, please contact us for a parish registration form.

 

FAMILY NAME:___________________________________________________________________________________________________

 

STUDENT NAME(S):_______________________________________________________________________________________________

 

ADDRESS:________________________________________________________________________________________________________

 

HOME PHONE:__________________________CELL (MOM):_________________________CELL (DAD):_________________________

 

E-MAIL ADDRESS:__________________________________________________________________________________OUR PRIMARY COMMUNICATION WITH YOU IS VIA E-MAIL.  CHECK HERE:_____IF YOU DO NOT HAVE AN E-MAIL ADDRESS

IN CASE OF AN EMERGENCY WHERE WE ARE NOT ABLE TO CONTACT YOU, PLEASE INDICATE THE PERSON(S) TO BE CONTACTED:

NAME:__________________________________________________________PHONE:____________________CELL:________________
 

MEDICAL OR /BEHAVIORAL CONDITIONS:____________________________________________________________________________________________________

 

FATHER OR MALE GUARDIAN                                                                   MOTHER OR FEMALE GUARDIAN

RELATIONSHIP TO CHILD:___________________________           RELATIONSHIIP TO CHILD:______________________________
 

NAME:___________________________________________________NAME:_________________________________________________

 

OCCUPATION:____________________________________________OCCUPATION:_________________________________________

 

BUSINESS PHONE:_________________________________________BUSINESS PHONE:______________________________________

 

RELIGION:________________________________________________RELIGION:_____________________________________________

 

MARITAL STATUS:________________________________________MARITAL STATUS:______________________________________

 

                                                                                                                                MAIDENNAME:_________________________________________

 

For the registration fee for the upcoming school year please call or email the Faith Formation Office.

All checks should be made payable to St. Timothy Church.

 
 

A COPY OF THE CHILD’S BAPTISM CERTIFICATE MUST BE PROVIDED FOR OFFICE RECORDS,(if baptized in a church other than St. Timothy/St. Rita), BEFORE ANY OTHER SACRAMENT CAN BE RECEIVED.  Please contact the Church where your child was baptized and have them fax us a copy of his/her Baptism Certificate.  Our Fax number is 738-2466.  In the event you child has not been baptized, please provide us with a copy of your child’s Birth Certificate.

If your child has had religious instruction elsewhere, please indicate their name(s) and the name of the parish.

STUDENT NAME(S):___________________________________________________________________________

CHURCH NAME:__________________________________________GRADE(S):___________________________

 

 

STUDENT 1   Faith Formation entering grade:________   Is this child in a different grade in school?  If so, what grade:_____

STUDENT NAME:____________________________________ MIDDLE NAME: __________________________________

DATE OF BIRTH____/____/____GENDER :_______________SCHOOL:_________________________________________

Has this child been adopted?  _____Yes _____No  If so, please provide a copy of the Adoption Certificate.

Student resides with:   (__both parents)   (___mother)   (___father)   (___other NAME:  _______________________________)

Are there any special circumstances regarding child custody or persons to whom your child may not be released?

If so, please explain.______________________________________________________________________________________

RELIGION:_____________________________ Has this student been baptized in the Roman Catholic Church?___YES___NO

Address of the Church where the student was baptized: __________________________________________________________

______________________________________________________________________________________________________

Has this student been baptized in another Christian denomination?  If so, please list:___________________________________

Has this student made his/her First Penance?                                       ___YES           ___NO

Has this student made his/her First Communion?                                            ___YES           ___NO

HEALTH PROBLEMS: __________________________________ Does your child have any allergies?      _____YES_____NO

Food(s):________________________________________________Other allergies:___________________________________

Does your child carry an Epi-Pen or have medication of any type with them?_________________________________________

Does your child have any special learning needs and if so, does he/she require any special accommodations?

If yes, please explain._____________________________________________________________________________________
 

STUDENT 2   Faith Formation entering grade:________   Is this child in a different grade in school?  If so, what grade:_____

STUDENT NAME:____________________________________ MIDDLE NAME: __________________________________

DATE OF BIRTH____/____/____GENDER :_______________SCHOOL:_________________________________________

Has this child been adopted?  _____Yes _____No  If so, please provide a copy of the Adoption Certificate.

Student resides with:   (__both parents)   (___mother)   (___father)   (___other NAME:  _______________________________)

Are there any special circumstances regarding child custody or persons to whom your child may not be released?

If so, please explain.______________________________________________________________________________________

RELIGION:_____________________________ Has this student been baptized in the Roman Catholic Church?___YES___NO

Address of the Church where the student was baptized: __________________________________________________________

______________________________________________________________________________________________________

Has this student been baptized in another Christian denomination?  If so, please list:___________________________________

Has this student made his/her First Penance?                                       ___YES           ___NO

Has this student made his/her First Communion?                                            ___YES           ___NO

HEALTH PROBLEMS: __________________________________ Does your child have any allergies?      _____YES_____NO

Food(s):________________________________________________Other allergies:___________________________________

Does your child carry an Epi-Pen or have medication of any type with them?_________________________________________

Does your child have any special learning needs and if so, does he/she require any special accommodations?

If yes, please explain._____________________________________________________________________________________
 

In the event of any emergency, I hereby give permission to transport my child/children to a hospital for emergency medical or surgical treatment.  I wish to be advised prior to any further treatment by the hospital or doctor.

Doctor:_________________________________________________________________Phone:_________________
 

Volunteer positions include:  Teacher, Aide, Sub, Hall Monitor, and Office Assistant

I wish to volunteer for: ___________________________________________________________________________________________

 

Even if you cannot volunteer for any of the positions above, do you have some particular talent you are willing to share, such as music, arts & crafts, sewing/altering costumes, drama experience, baking, etc.?       ___Yes                  ___No

Please list: ________________________________________________________________________________________________________
When I had my child/children baptized, I accepted responsibility as primary religious educator and example in matters of the faith.  I know that the Church is here to support me in educating my child in our Catholic faith.

 

PARENT SIGNATURE:___________________________________________________DATE:_________________